Provider Demographics
NPI:1285794610
Name:DE LOS REYES, ARLENE (N P)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:
Last Name:DE LOS REYES
Suffix:
Gender:F
Credentials:N P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 1901
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-441-1100
Mailing Address - Fax:713-790-2643
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 1901
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-441-1100
Practice Address - Fax:713-790-2643
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX586461363L00000X
TXAP115293363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00433683OtherRAILROAD MEDICARE
TXP01402883OtherRR MEDICARE
TXP01142151OtherRR MEDICARE
TX185069503Medicaid
TX8Y1360OtherBCBS
TX185069501Medicaid
LA1800791Medicaid
TX185069502Medicaid
TX185069504Medicaid
TX8Y1360OtherBLUE CROSS BLUE SHIELD
TX185069503Medicaid
TX185069504Medicaid
LA1800791Medicaid